Walter A. Brown - Lithium: A Doctor, a Drug, and a Breakthrough

New York and London: Liveright; 2019 (288 page)

Reviewed by Walter A. Brown


Information on Contents

        This book’s eight chapters chronicle the discovery of lithium as a treatment for manic-depressive illness. The introduction provides an overview of the discovery, it’s place in the history of psychopharmacology , the context in which it occurred. and the roles of some of the key players. Chapter One, Manic-Depressive Illness, a Brief History  is just that. It recounts the knowledge of manic-depressive illness, with a particular emphasis on its treatment, from antiquity until the mid-20th century when Cade reported his breakthrough. Chapter Two, The Naturalist, is about John Cade, the man. It takes us from his early life, through his education and early research endeavors to his incarceration at Changi, the notorious Japanese POW camp.  This chapter points to some of Cade’s experiences and attributes that might have influenced the course of his research and its culmination in his observation that lithium curtailed mania. . Chapter Three, Lithium, details what we know about this lightest of metals, from its arrival 14 billion years ago with the big bang, through its discovery in the early 19th century, to its medical applications and its embrace as a panacea at the end of the 19th century. Chapter Four, Breakthrough, describes the research that Cade did with guinea pigs, research  that now has a mythic place in the history of psychopharmacology, It depicts in detail the clinical trial that followed and the controversies around some of its  results, how Cade reported them and how others saw them.  The next chapter, Aftermath, recounts the fate of lithium treatment in the early years after Cade’s 1949 report. We hear about the substitute salt debacle, the pivotal research of Trautner, Talbott, Schou and others and the obstacles to lithium’s acceptance. Chapter Six, Prophylaxis Rex, portrays the efforts of Mogens Schou and his colleagues to establish lithium’s value as a prophylactic agent. It also depicts the struggle to get lithium approved in the US and the troupe of determined psychiatrists who made it happen. The final chapter, Epilogue, returns to Cade, describing his later career and the recognition he, somewhat belatedly,  got for his lithium discovery. It also discusses lithium’s current place in psychiatric treatment, its renaissance and promising new applications.

Author’s Comment

        This book is meant for a general audience. Although it is suitably annotated and its contents well documented and, I believe, accurate it is not fundamentally a scholarly text.  Rather it is a story about a scientific discovery and the unlikely fellow who pulled it off. More broadly it is an illustration of the scientific process. Much of the material will be familiar to lithium experts and those interested in the history of psychopharmacology.  Still, some may find the detailed portrayal of the connections linking the lithium researchers of some interest.


September 26, 2019